Children as Mystics, Activists, Sages, and Holy Fools: Understanding the Spirituality of Children and Its Significance for Clinical Work

This article explores children's spirituality and its significance for health care providers seeking to provide “spiritually competent care” of children amidst religious and spiritual diversity. Four metaphors of different spiritualities evidenced among children are explored: mystics, activists, sages, and holy fools. The article addresses issues clinicians face such as the problem of defining spirituality in relation to religion, and countertransference around religious and spiritual matters. Current research shows that spiritual and religious involvements constitute positive factors promoting resiliency and health in children. James W. Fowler's theory of faith development facilitates an exploration of questions concerning how children develop a belief system, leading to a view of children's spirituality as multidimensional. This article preserves the less formal conversational style of an earlier version's presentation in Grand Rounds at the UCLA Medical Center's Neuropsychiatric Hospital on December 10, 2003.     

The Order of Widows: what the early church can teach us about older women and health care.

This article argues that the early Christian "order of widows" provides a fruitful model for Christian ethicists struggling to address the medical and social problems of elderly women today. After outlining the precarious state of the "almanah"--or widow--in biblical times, it describes the emergence of the order of widows in the early Church. Turning to the contemporary situation, it argues that demographics both in the United States and around the globe suggest that meeting the needs of elderly women will become an enormous challenge in the years to come. The order of widows illustrates a three-fold conception of solidarity that has immediate implications today. That conception of solidarity encourages us: 1) to identify the unique medical needs of elderly women (e.g., osteoporosis); 2) to find ways of overcoming their societal isolation, which can increase their risk of medical and psychological problems; and 3) to develop strategies for enabling them to remain contributing members of the community for as long as possible.     

前瞻性情绪作为社会风险的信息源假说：公共场景下风险决策的情绪及文化机制探讨

本研究从梳理决策的情绪理论入手, 在综合几种主要理论的基础上提出了“前瞻性情绪作为社会风险信息源”的假说。前瞻性情绪是在决策过程中产生的, 由于对决策选择的预期而感受到的, 进而影响决策行为的情绪。社会环境下的风险事件具有突发和稍纵即逝的特征, 如果一个公民对这类风险事件做出反应, 其结果的概率难于量化。在这种情况下, 前瞻性情绪能够为决策者快速提供有关信息, 并形成对决策预期结果严重性和可能性的综合表征, 从而成为公众场景下风险决策的有效线索。不同前瞻性情绪的组合在面对社会性风险事件时具有针对性的作用。近年来在文化比较中对于面子、荣誉和尊严文化的划分, 也为我们研究文化的情绪特征和行为效应提供了理论框架。本研究拟通过四项研究和多个实验探讨前瞻性情绪如何影响公众场景下人们的风险应对行为, 并对三种文化的情绪特征进行比较, 探索情绪性决策中个人因素、群体因素、及文化因素如何共同决定公共场景下风险决策(如亲社会行为或反社会行为)的发生与发展, 同时也期望为公共政策的制定及风险管理提供科学依据。     

Continuity of aggression from childhood to early adulthood as a predictor of life outcomes: implications for the adolescent‐limited and life‐course‐persistent models

Using data from the Columbia County Longitudinal Study, a 40‐year longitudinal study following an entire county's population of third‐grade students from age 8 to 48, we examine questions about the long‐term consequences of aggressive and antisocial behavior in childhood, adolescence, and young adulthood. We found moderate levels of continuity of aggression from age 8 to 48 both for males and for females. Contrary to what some have proposed, we found that continuity of aggressiveness is owing to not only the high‐aggressive participants staying high but also owing to the low‐aggressive participants staying low. Compared with life‐course‐persistent low aggressives, we found that life‐course‐persistent high aggressives had consistently poorer outcomes across domains of life success, criminal behavior, and psychosocial functioning at age 48 (e.g., arrests, traffic violations, aggression toward spouse and divorces, depression, health, occupational and educational attainment). In contrast, adolescent‐limited and child‐limited aggressives did not differ from life‐course‐persistent low aggressives on the age 48 outcomes. Finally, the outcomes for late‐onset (early adulthood) aggressives were also problematic in some domains though not as problematic as those for life‐course‐persistent aggressives. Aggr. Behav. 35:136–149, 2009. © 2009 Wiley‐Liss, Inc.     

The search for peer advice in cyberspace: An examination of online teen bulletin boards about health and sexuality

The physical, emotional, and psychological changes that occur in adolescence prompt youths to have serious questions about their bodies, relationships, and health that are often personal, sensitive, or embarrassing. Past research has shown that adolescents are often reluctant to consult physicians, peers, and others for personal health questions due to concerns about confidentiality. One new venue for health information is the Internet, which is a promising resource due to its accessibility, interactivity, and anonymity. This study is a snapshot investigation of a popular health support website, which utilized a peer-generated bulletin board format to facilitate the discussion of adolescent health and social issues. Analyses of two health bulletin boards—one on teen issues and one on sexual health—were conducted on the questions and replies found on 273 topics of mainly anonymous adolescents collected over a 2-month period. Results revealed that the questions most frequently posted and viewed reflected interests and concerns about their changing physical, emotional, and social selves: Romantic relationships were the most frequent topic on the teen issues bulletin board; sexual health was the most frequent topic on the sexuality bulletin board. The bulletin boards proved to be a valuable forum of personal opinions, actionable suggestions, concrete information, and emotional support and allowed teens to candidly discuss sensitive topics, such as sexuality and interpersonal relations.     

The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder

Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen’s κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD.